L-- *Last. A~~roved Dutv Type Assi~nment Checked Source & Hours. can. 1:50:20 6:30 AM 7:30 PM Shift PM 9 Res F les Comments

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1 Name Jodie Grandominico PGY-3 Categorical Track Residency Start date: July 1,26 End date: June 3,29 Date - 2/2/9 Director's Comments: meeting with Dr. Rouan. Subspecialty Interests: Awards and Recognition: / CEX exams completed 8-9: Professionalisnl Index: ITE exam Results: ck L-- Pre-/Post- Rotation Examination Scores: Duty Hour Compliance Report and Comments: Dav Start End *Last A~~roved Dutv Type Assi~nment Checked Source & Hours VA 1 Non 1/7/29 12/1/28 12/1/28 Shift r ~dit can 1:5:2 6:3 AM 7:3 PM Shift PM Res Res 13. Comments Details 9 Res F les 31.5 Comments r ~dit I- Edit r ~alt VA 1 Non 1/7/29 12/4/28 12/4/28 Shift Call 1:5:2 Res Thu 6:OOAM 7: PM Shift PM Res 13. Comments Details VA 1 Non 1/7/29 12/5/28 12/5/28 Shift Call 1:5:2 Res Fri 7: AM 5:3 PM Shift PM Res 1.5 Comments Details 1/7/29 12/6/28 12/7/28 Call 1:51:1 Sat 6:3 AM 11:3 AM Call PM Res Res 29. Comments Details r mt 12/8/28 12/8/28 Shift Call VA 1 Non 1/7/29 6:3 AM 4:3 PM 1:51:1 Shift PM Res Res 1. Comments Details r ~dit Tue 12/9/28 12/9/28 Shift VA 1 Non 1/7/29 Res Res 1. Comments Details

2 r ~dit Wed 7:OOAM 11:3AM 12/1/28 12/11/28 Call Call 1:51:1 Shift PM Call 1111/29 7:4:47 PM Res Res 28.5 Comments Details r ad 12/12/28 12/12/28 Shift Call Fri 6:3 AM 3:3 PM VA 1 Non 1/11/29 7:4:47 Res Res 9. Comments Details Shift PM 1/12/29 12/14/28 12/15/28 Call 7:29:56 Res Res 29. Comments ~etails Sun 6:3 AM 11:3 AM Call PM r w 12/16/28 12/16/28 Shift Call Tue 6:3 AM 4:3 PM VA 1 Non 1/28/29 2:8: Res Res 1. Comments Details Shift AM VA 1 Non 1/28/29 12/17/28 12/17/28 Shift Call r mt 2:8: Res Res 8. Comments Details Wed 7: AM 3: PM Shift AM 1/28/29 12/18/28 12/19/28 Call 2:8: Res Res 29.5 Comments Details Thu 7: AM 12:3 PM Call AM 1/28/29 12/22/28 12/23/28 Call 7:OOAM 12: pm 2:1:22 Res Call AM 29. Comments Details VA 1 Non 1/28/29 12/24/28 12/24/28 Call r a t 2:1:22 Res Wed 7: AM 12:3 PM Shift AM Res 5.5 Comments Details VA 1 Non 1/28/29 12/25/28 12/25/28 Shift Call r ~t 2:1:22 Res Thu 7:OOAM 1:OO AM Shift AM Res 3. Comments Details P Ed~t Delete Fri 1/28/29 12/26/28 12/27/28 Call 7: AM 12:OO PM Call AM 2:1:22 Res 29. Comments D&& I- Edit 12/29/28 12/3/28 Call Call 2:11:16 Res Res 29.5 Comments Details 6:3 AM 12:OO PM 1/1/29 1/2/29 Call Call r Ed& 2:11:16 Res Res 29. Thu 7: AM 12:OO PM r ~t 1/4/ Shift Day 2:11:16 Res Res 1. Comments ~etails Sun 6:3 AM 4:3 PM l- Edit 1/5/29 1/6/29 Call Call 7: AM 1: PM 2:11:16 Res Res 3. I Comment: r ~a 1/ Shift Day 2:11:16 Res Res 11.5 Con7rnents ~etails Thu 7: AM 6:3 PM 1/9/29 1/1/29 Call Call 2:11:16 Res Res 3. Comments Details Fri 6:3 AM 12:3 PM 1/11/29 1/11/29 Shift r ~clit Day 2:11:16 Res Res 11.5 Comments Details Sun 7: AM 6:3 PM 1/12/29 1/12/29 Shift r ECJ Day 2:11:16 Res Res 1. Comments!?&& 7: AM 5: PM

3 r a t r ~ dis r ~dit Tue 1/13/29 1/14/29 Call Call 2:ll: 16 Res 7: AM 12:OO PM Res 29. Comments Details 1/16/29 1/17/29 Call Call 2:11:16 Res Fri 7: AM 12:OO PM Res 29. Comments Details 1/19/29 1/19/29 Shift 7: AM 5:3 PM Day 2:11:16 Res Res 1.5 Comments Details Tue 1/2/29 1/21/29 Call Call 2:11:16 Res 7: AM 12:3 PM Res 29.5 Comments 1/22/29 1/22/29 Shift Day 2:11:16 Res Thu 12:OOAM 12:3 PM Res 12.5 Comments Details r E UH MICU 1/28/2( 19 1/23/29 1/23/2 Shift Res Fri 12:OO AM 1: PM Day 2:11:16 R Comments Details 1/24/29 1/24/29 Shift r E ~ U Sat 12:OO AM 12:OO PM Day 2:11:16 Res Res 12. Comments petails 1/25/29 1/25/29 Shift Sun 12:OOAM 12:OO PM Day 2:11:16 Res Res 12. Comments Details 1/26/29 1/26/29 Shift 12:OO AM 1: PM Day 2:11:16 Res Res 13. Comments Details 1/27/29 1/27/29 r E& Day 2:11:16 Res Tue 12:OO AM 12:OO PM Res 12. Comments Details 1/28/29 1/28/29 Shift Delete Wed 12: AM 12:OO PM Day 2:11:16 Res 12. Comments Details Ex~r-t to Excel Delinquent Medical Record: Resident Rotation/Faculty/Progranl Evaluation Compliance: MentorIDr. Diers Reports and Comments: Letters of Commendation/Concern: Clinical Quality Performance Reports: I I I l l l N S L l l \ I I ETIOLOGY IN A 67-YEAR-OLD MALE.<>Short Tenn Affect of HAART on Blood Pressure in HIV Infected Ilidividuals Poster Presentation Publications Ohio ACP - Columbus, OH HIV Clinical Trials I.lo Oral 1- Presenta 25-7

4 Poster Presenta Performance Review: Strengths: Overall: Procedures and Comments: %of Confirmed C P Credent~al ~ Total - T Confirmed (Not O/O for Credent~al T a Procedure Name Code Tarqet Loqqed Loqqed (Passed) Passed) (ConfirmedtPassed) Refused Abdominal Paracentesis (Internal Arterial Line (Internal Arterial Puncture Blood Gas (Internal Bone Marrow Biopsy (Internal Bone Marrow Bx (Internal Bronchoscopy (Internal Central Venous Femoral Line Insert (Internal Central Venous Internal Jugular (Internal Central Venous Subclavian Pun (Internal Certified By Acls-L1 (Internal Certified By Acls-L2 (Internal Certified By Laboratory Medicine Course (Internal Chest Roentgenogram Interp (Internal Chest Tube Insertion (Internal Colposcopy (Internal Conscious Sedation IM/IV (Internal Cordis Catheter Internal Jugular (Internal Cordis Catheter Subclavian (Internal Echcardiography (Internal Ekg Interpretation (Internal Ekg Perform (Internal Emergent Cardioversion (Internal Endotracheal Intubation

5 (Internal Floey Catheter (Male) (Internal Fluoroscopy (Internal Foley Catheter (Female) (Internal Gram Stain Of Sputum (Internal Holter Monitor Interp (Intern; I & D of Abscess (Internal I And D Abcess (Internal Indirect Laryngoscopy (Internal InsettjPlcrnt Swan Ganz (Internal Insertion Arterial Line (Internal Insertion Central tine Catheter (Internal Interp Rightside Catheter Tracing (Internal Intradermal Injection (Internal Intubation Endotracheal (Internal Joint Aspiration (Internal Joint Aspiration Knee (Internal Joint Injections (Internal Laceration ClosureIRepair (Internal Lumbar Puncture (Internal Maintenance Of Open Airway (Internal Manage-Mechanical Vent (Internal Microscopic Exam Of Urine (Internal Mini-CEX (Internal Mole Removal (Internal Nasogastric Intubation (Internal Orogastic Intubation (Internal Pap And Pelvic Examination (Internal Pericardioncentesis Emergent (Internal Peripheral Blood Smear Interp (Internal

6 Peripheral Iv Lines (Internal Peritoneal Lavage (Internal Peritoneocentesis/Paracentesis (Internal Placement-External Pacer (Internal Plcmt of Temp Jugular and Femoral Catheters for Dialysis (Internal Pleural Needle Biopsy (Internal Pulmonary Artery Catheter Plac (Internal Quinton Catheter (Internal Radiation Producing Devices (Internal Sigmoidoscopy Flexible (Internal Skin Biopsy (Punch) (Internal Spirometry-Pulmonary Function (Internal Subcutaneous Injection (Internal Suture Removal (Internal Temporary Pacer Placement Emerg (Internal Tenkoff Catheter (Internal Thoracentesis (Internal Thoracentesis Aspiration (Internal Tonometry (Schioh) (Internal Treadmill Exercise Study (Internal Trigger Point Injections (Internal Triple Lumen Catheter (Internal Vaginal Discharge-CandITrich (Internal Vein Puncture (Internal ExDort to Excel Overall Totals: Overall Total Loggec! 41 Overall Oh of Total Ovcrall Total ( lverall Tot: 11 Not Overall Overall Total Log1 ged Passed Passed I Credenti Refused 9.11% %

7 Comments: Summary and Evaluation Comments: Evaluation of Resident UNIVERSrrY OF CINCINNATI MEDICAL CENTER DEPARTMENT OF INTERNAL MEDICINE EVALUATION OF RESIDENT Category/Queslion PATIENT CARE Incomplete, inaccurate medical interviews, physical examinations, and review of other data; incompetent performance of essential procedures; fails to analyze clinical data and consider patient preferences when making medical decisions PATIENT CARE Medical Interviewing: Incomplete, illogical, superficial PATIENT CARE Physical Examination: Incomplete, inaccurate, cursory, nondirected, unreliable PATIENT CARE Procedural Skills: Inept, careless, disregards risk and discomfort to patients Superb, accurate, comprehensive medical interviews, physical examinations, review of other data, and procedural skills; always makes diagnostic and therapeutic decisions based on available evidence, sound judgement, and patient preferences Logical, thorough, and efkient. Complete and accurate. Proficient, minimizes patients' discomfort. MEDICAL KNOWLEDGE Exceptional Limited knowledge knowledge of basic of basic and and clinical sciences; clinical sciences; highly resourceful minimal interest in development of learning; does not knowledge; understand comprehensive complex understanding of relationships, complex mechanisms of relationships, disease mechanisms of disease PRACTICE-BASED LEARNING AND Scale R-3 Average Average Staiidard Mlnlrnum Max~rnum Deviation

8 IMPROVEMENT Fails to perform self-evaluation; lacks insight, initiative; resists or ignores feedback; fails to use information technology to enhance patient care or pursue selfimprovement INTERPERSONAL AND COMMUNICATION SKILLS Does not establish adequate, effective, humanistic and therapeutic relationships with patients and families; conveys poor, ineffective listening, narrative or nonverbal skills; does not provide education or counseling to patients, families, or colleagues. PROFESSIONALISM Lacks respect, compassion, integrity, honesty; disregards need for self-assessment; fails to acknowledge errors; does not consider needs of patients, families, colleagues; does not display responsible behavior SYSTEM-BASED LEARNING Unable to access/mobilize outside resources; resists efforts to improve systems of care; does not use systematic approaches to reduce error and improve patient care Constantly evaluates own performance, incorporates feedback into improvement activities; effectively uses technology to manage information for patient care and self-improvement Establishes highly effectrve humanistic and therapeutic relationships with patients and families; demonstrates excellent listening, narrative and nonverbal skills; successful in educating and counseling patients, families, and colleagues; always "interpersonally" engaged Always demonstrates respect, compassion, integrity, honesty; teaches/role models responsible behavior; total commitment to self-assessment; willingly acknowledges errors; consistently considers n eeds of patients, fa milies, colleagues Effectively accesses/utilizes outside resources; effectively uses systematic approaches to reduce errors and improve patient care; enthusiastically assists in developing systems' improvement OVERALL CLINICAL COMPETENCE This rating represents your assessment of the resident's overall performance during

9 this month of training. Superior: Far exceeds reasonabl expectations. Satisfactory: Always meets and occasionally exceeds reasonable expectations. Marginal: Meets some expectations but occasionally falls short. Unsatisfactory: Consistently falls short of reasonable expectations. OVERALL CLINICAL COMPETENCE 11 Has this form be reviewed by the Boolean No (5) resident? OVERALL CLINICAL COMPETENCE 12 Number of patients admitted during this Comment rotation OVERALL CLINICAL COMPETENCE Number and types of procedures done Boolean Yes l3 during this rotation were reviewed and documented (2) OVERALL CLINICAL COMPETENCE 14 Medical Records, e.g. Boolean dictationlsignatures, are comple OVERALL CLINICAL COMPETENCE l5 Attending's Comments (Required): Comment Evaluator Question Cotnments Herzig, Edward B. 11/14/28 12) NONE IM-Primary Care-UH Knepler, lames 12) -15 consults 12/11/28 IM-PUL-VA Herzig, Edward 15) For the short exposure time, she was very good. However, she was only here for a couple of sessions 11/14/28 due to scheduling. She should make a very good physician. IM-Primary Care-UH Bernstein, Jonathan 11/18/28 15) I did not interact with Dr. Grandominico. IM-Primary Care-UH Johnson, KaY 15) Jodi is through and competent. She can assess patients independently and follow through on patient 12/3/28 care. Her diagnostic skills are right on. Most importantly she is reliable and caring about the patients. IM-GIM-UH Knepler, $~~28 15) Very enthusiatic and interested in working. Hardworking. A pleasure to be on service with IM-PUL-VA Ohlbaum, 15) Dr. Grandominico was an excellent team leader. She is organized and thorough and careful in her Yes (3)

10 Karen assessments. She is a good teacher and role model for the other members of the team. 1/3/29 IM-VA1-VA Marcheschi, Ed 1/4/29 15) Dr. Grandominico was very attentive and motivated to learn in the clinic. IM-Primary Care-UH Evaluation PATIENT CARE of Team Incomplete, Superb, accurate, Leader inaccurate medical comprehensive ::~~~~~$ interviews, physical medical interviews, examinations, and physical OF CINCINNAn review of other examinations, review data; incompetent of other data, and 1 performance of procedural skills; CENTER always makes DEPARTMENT ~ ~ ~ ~ fails ~ to ~ diagnostic! e s and ; OF INTERNAL analyze clinical therapeutic decisions MEDICINE data and consider based on available patient preferences evidence, sound OF TEAM LEADER 28- when making judgement, and medical decisions patient preferences 29 PATIENT CARE Checkbox Performance needs attention MEDICAL KNOWLEDGE Limited knowledge of basic and clinical sciences; minimal interest in learning; does not understand complex relations, mechanisms of disease MEDICAL KNOWLEDGE Performance needs attention Exceptional knowledge of basic and clinical sciences; highly resourceful development of knowledge; comprehensive understanding of complex relationships, mechanisms of disease PRACTICE-BASED LEARNING AND IMPROVEMENT Fails to perform self-evaluation; lacks insight, initiative; resists or ignores feedback; fails to use information technology to enhance patient care or pursue selfimprovement Constantly evaluates own performance, incorporates feedback into improvement activities; effectively uses technology to manage information for patient care and self-improvement Checkbox PRACTICE-BASED LEARNING AND 6 IMPROVEMENT Checkbox Performance needs attention INTERPERSONAL AND COMMUNICATION SKILLS ' 1-9 Does not establish Establishes a highly even minimally effective therapeutic

11 effective relationship with therapeutic patients and families; relationships with demonstrates patients and excellent relationship families; does not building through demonstrate ability listening, narrative to build and nonverbal skills; relationships excellent education through listening, and counseling of narrative or patients, families, nonverbal skills; and colleagues; does not provide always education or interpersonally counseling to engaged patients, families, or colleagues INTERPERSONAL AND 8 COMMUNICATION SKILLS Performance needs attention PROFESSIONALISM Lacks respect, compassion, integrity, honesty; disregards need for self-assessment; fails to 9 acknowledge errors; does not consider needs of patients, families, colleagues; does not display responsible behavior PROFESSIONALISM Performance needs attention Always demonstrates respect, compassion, integrity, honesty; teacheslrole models responsible behavior; total commitment to self-assessment; willingly acknowledges errors; always considers needs of patients, families, colleagues SYSTEM-BASED LEARNING Unable to Effectively accesslmo bilize accesses/utilizes outside rer ;ources; outside resources; actively resists effectively uses efforts to improve systematic 11 systems of care; approaches to does not use reduce errors and systematic improve patient approache s to care; enthusiastically reduce erv or and assists in developing improve pi 3tient systems care improvement SYSTEM-BASED LEARNING l2 Performance needs attention SYSTEM-BASED LEARNING 13 Residents Overall Clinical Competence in Internal Medicine on Rotation SYSTEM-BASED LEARNING l4 Performance needs attention SYSTEM-BASED LEARNING l5 Interns Comments Checkbox Checkbox Checkbox Checkbox Comment

12 Evah~ator Question Comments..-. Mendenhall, Cole Fredrick Paul 1/19/28 15) Jodi is caring, competent and charming. She is also a fantastic-teacher. IM-Night Med Team- UH Varghai, Houman 1/ ) Very enthusiastic and hard worker. IM-Night Med Team- UH Lester, Tiffany 1/29/28 15)1 IM-Night Med Team- UH Cunningham, Claire Angela 1/3/28 15) Jodi provided a good amount of teaching on this rotation, and going over patient plans with her was IM-Night very helpful. Med Team- Veer 15) Jodi was an awesome senior!! I enjoyed working a lot with her and learning from her. She is very IM-VA1-VA professional and up to date in her medical knowledge. She is a great team leader. Notes: A blank Standard Deviation indicates that there is either no deviation (only one score) Export to Excel Signature Date